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Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Research

Associations between intimate partner violence and reproductive and maternal health outcomes in Bihar, India: a cross-sectional study

Authors: Diva Dhar, Lotus McDougal, Katherine Hay, Yamini Atmavilas, Jay Silverman, Daniel Triplett, Anita Raj

Published in: Reproductive Health | Issue 1/2018

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Abstract

Background

Bihar, India has higher rates of intimate partner violence (IPV) and maternal and infant mortality relative to India as a whole. This study assesses whether IPV is associated with poor reproductive and maternal health outcomes, as well as whether poverty exacerbates any observed associations, among women who gave birth in the preceding 23 months in Bihar, India.

Methods

A cross-sectional analysis of data from a representative household sample of mothers of children 0–23 months old in Bihar, India (N = 13,803) was conducted. Associations between lifetime IPV (physical and/or sexual violence) and poor reproductive health outcomes ever (miscarriage, stillbirth, and abortion) as well as maternal complications for the index pregnancy (early and/or prolonged labor complications, other complications during pregnancy or delivery) were assessed using multivariable logistic regression, adjusting for demographics and fertility history of the mother. Models were then stratified by wealth index to determine whether observed associations were stronger for poorer versus wealthier women.

Results

IPV was reported by 45% of women in the sample. A history of miscarriage, stillbirth, and abortion was reported by 8.7, 4.6, and 1.3% of the sample, respectively. More than one in 10 women (10.7%) reported labor complications during the last pregnancy, and 16.3% reported other complications during pregnancy or delivery. Adjusted regressions revealed significant associations between IPV and miscarriage (AOR = 1.35, 95% CI = 1.11–1.65) and stillbirth (AOR = 1.36, 95% CI = 1.02–1.82) ever, as well as with labor complications (AOR = 1.27, 95% CI = 1.04–1.54) and other pregnancy/delivery complications (AOR = 1.68, 95% CI = 1.42–1.99). Women in the poorest quartile (Quartile 1) saw no associations between IPV and miscarriage (Quartile 1 AOR = 0.98, 95% CI = 0.67–1.45) or stillbirth (Quartile 1 AOR = 1.17, 95% CI = 0.69–1.98), whereas women in the higher wealth quartile (Quartile 3) did see associations between IPV and miscarriage (Quartile 3 AOR = 1.55, 95% CI = 1.07, 2.25) and stillbirth (Quartile 3 AOR = 1.79, 95% CI = 1.04, 3.08).

Discussion

IPV is highly prevalent in Bihar and is associated with increased risk for miscarriage, stillbirth, and maternal health complications. Associations between IPV and miscarriage and stillbirth do not hold true for the poorest women, possibly because other risks attached to poverty and deprivation may be greater contributors.
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Metadata
Title
Associations between intimate partner violence and reproductive and maternal health outcomes in Bihar, India: a cross-sectional study
Authors
Diva Dhar
Lotus McDougal
Katherine Hay
Yamini Atmavilas
Jay Silverman
Daniel Triplett
Anita Raj
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0551-2

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